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VAERS ID: 1000247

AGE: UNK| SEX: F|State: FR

Description

died; This is a spontaneous report from a contactable physician downloaded from the Medicines Agency (MA) WEB [AT-BASGAGES-2021-00572]. A 86-year-old female patient received BNT162B2 (COMIRNATY) on Jan2021 Intramuscular at single dose for COVID-19 immunisation. The patient's medical history included: Dementia (continuing), Ataxia (continuing), Transient ischaemic attack (TIA), Struma nodosa (continuing). Concomitant medication was not reported. The patient died a few days after receiving the Covid vaccination on 25Jan2021. It was unknown if autopsy was done. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: unknown cause of death

Symptoms

Death

Vaccines

VAX DATE: 31 December 2020 | ONSET DATE: 24 January 2021 | DAYS TO ONSET: 24
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK
  • OT
  • Unknown

RECVDATE:
03 February 2021
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
Y
DATEDIED:
24 January 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
N
LAB_DATA:
V_ADMINBY:
OTH
OTHER_MEDS:
CUR_ILL:
Ataxia (Ataxia); Dementia (Dementia); Struma nodosa (Struma nodos)
HISTORY:
Medical History/Concurrent Conditions: TIA (Status post TIA)
PRIOR_VAX:
SPLTTYPE:
ATPFIZER INC2021089054
FORM_VERS:
2
TODAYS_DATE:
02 February 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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